Tuesday, 27 March 2012

Winnipeg's first Quick Care Clinic opened recently at 363 McGregor Street. On my way to work this morning, I spied another one opening up in the freshly re-clad IC Computing building on St.Mary's near Marion.

(It looks better now) pic: Google maps

This would be the St.Boniface location, of the 8 planned for Manitoba. It's an easily accessible location and occupies a building that has been vacant for a year or two, which is nice to see.

Of the McGregor location, our Minister of Health, Theresa Oswald, declared "This new clinic is about offering patients choice."

Part of us wonders how much choice these new clinics really add. There are, of course, medical clinics already scattered throughout the city. They are privately owned and staffed by doctors who can perform all of the same services that the new Quick Care Clinics provide and more. Is this just a case of the government branching out into the territory of private enterprise and cannibalizing their business?

The big draw seems to be the extended hours: open until 9:00 pm weekdays and 5:00 pm on weekends and holidays. In that regard it will be better than most private clinics, including the one in my neighbourhood, which is due to get a new QCC sometime in the near future.

In theory, the clinics should be cheaper because they are staffed by registered nurses and nurse practitioners instead of doctors. Nurses are well paid, but the doctors who work in walk-in clinics get paid based on how many patients they push through the gates every day, not an annual salary. This may result in a rushed experience for some people, and perhaps that's another advantage of the new clinics -- the salaried nurses may take a little more time mending the burnt hand you got experimenting with deep-frying marshmallows.

The concept of a nurse practitioner clinic is not new in Manitoba. Internet pharmacy mogul Darren Jorgenson opened the Four Rivers Medical Clinic in 2010 to perform basic medical care for a fee. This no doubt pissed off the folks on Broadway and is very likely the impetus for the new Quick Care Clinics that you see now.

So if these clinics have longer hours and cheaper health care providers, it's all good, right? Well, equipping and staffing the clinics themselves will be costly. How do you tell if the increased "choice" offsets the increased cost to taxpayers? As well, this could also have a negative effect on certain actual medical clinics. If all the people with easily treatable wounds and coughs go to the QCCs, the actual clinics will be left with fewer and more complicated patients. With fewer people going through, and more time spent per treatment, profits will drop.

I have to wonder, for example, what might become of the small Lang Medical Clinic when the new St.Mary's Quick Care Clinic opens up only one block away. The people in the area might have gained a nurse practitioner, but lost a doctor.

If you have time to read on, Dan's path of logic is as follows (if I may summarize):

o Every province has a bad deficit except those with expanding oil and gas revenue.o Were it not for the flood, we'd be doing quite well in comparison.o Increased spending is to be expected because of inflation.o (ad hominem shot at Federal government)o Manitoba has been cutting taxes and balancing the budget for 10 years.o we do not have a spending problem.o cutting spending would harm the economyo therefore increasing taxes is the answer

Let's start at the start. Yes, every province but two ran deficits, some larger than Manitoba's, but to put it in better perspective you should look at it on a per capita basis:

Manitoba, as you can see, has the second largest deficit per head, and that chart was published on March 5 using an old estimate. With the new estimate of $1.12 billion, the per capita total is $926.

Sure you could blame it on the flood, but factoring out the flood completely still leaves us with a deficit of $521 per capita. But to really gauge a spending problem you need to look at the trend. Dan says that it is "an accepted reality" that spending will go up because of inflation. Sure, except that inflation has been around 2% per year since John Crow was Governor of the Bank of Canada, whereas provincial government spending has been increasing at over 5% per year since 1999.

Even worse, since the NDP has taken office the Manitoba Government has over spent its budget every single year. "Deficits are not forensic evidence of a spending problem", Dan says. No, not necessary, but here is a chart that compares the budgeted spend vs. the actual spend by year:

THAT, my friends, is a spending problem. There were a couple of years where Gary Doer kept the overspend to a modest amount, but since 2003 they haven't even come close. Of course ... there was a flood every single year. Maybe that's why they went over. [end sarcasm]

Maybe they overspent, but they also balanced the budget and cut taxes, you might respond.

Did they? Did they really? They complied with the balanced budget legislation, which is a completely different thing, and when the loop holes weren't big enough anymore they gutted the balanced budget legislation. If they were balancing the budget then riddle me this: how did the provincial debt climb to $26 billion?

And to say they cut taxes is crazy talk. Personal income taxes are higher than when the NDP took office in 1999, and corporate taxes are the highest west of Quebec. They may have implemented specific boutique tax credits and modest cuts here and there, but it is far more accurate to say they increased taxes because of bracket creep. See here for an explanation or watch the video. All of this leaves us with the highest personal taxes outside of Quebec for anyone earning less than $50k, and almost the highest for anyone over that.

But will cutting spending harm our fragile economic recovery? No.

First of all, the economic recovery depends on global and national factors far more than any factors in our little micro economy in Manitoba.

Secondly, the Keyensian policies of using fiscal stimulus like government spending to guide the economy have been widely discredited disputed by economists.* It does have an impact, but it is weak and functions with a lag, making it inefficient and ineffective. Dan takes us back to the 1990s "when governments slashed spending on core services to slay the deficit dragon" as a lesson about the long term costs of such policies, but it is those very policies that built the foundation of the advantageous position that we're in now as a country.

Lastly, Dan's proposal to raise taxes would have much the same effect as cutting spending would. Both are negative demand shocks, that is, they have a negative impact on aggregate demand, that is, they hurt the economy temporarily. The difference is that increasing taxes would exacerbate our problem of being uncompetitive with the provinces around us, whereas cutting spending would help put us back on better financial footing. We are already losing jobs and talent to other provinces. Let's not make it worse.

*edited. "discredited" implies that there is concensus, when there are really competing views. The criticism is not that government spending does not boost the economy, but that it is a poor way to do so for the reasons mentioned above (inefficient, delayed impact).

Sunday, 11 March 2012

I bought a new Nikon S9100 recently. When you buy a Nikon you are invited to join their free photo sharing website My Picturetown, where you can share photos, and arrange them into galleries called photomoves.

I thought, why not? I could make use of a photo sharing website. While I usually disregard the legal mumbo-jumbo of signing up for products or services, I decided to give this one a look. Maybe it was this recent article about Pinterest that peaked my interest in legal terms of service.

Under a section called Intellectual Property I found this:

You hereby grant to Nikon a worldwide, royalty-free, fully paid-up, perpetual, irrevocable, non-exclusive, full right and license to publish, copy, reproduce, modify, exhibit, perform, exploit, display, transmit, distribute, make derivative works of, license, include in compilations, and/or otherwise use User Content contained in any and all Photomovies, in any format and through any means, in any media now known or hereafter created, for any purpose whatsoever.

That is absolutely terrible. If you post a picture of your Grandma, Nikon can stick the head of a donkey on her and "exploit" her in ways not presently known to man, and there's not a damned thing you can do about it.

Are other photo sharing sites this bad? I may just have to continue using my personal web site to share photos. It's a bit of a pain, but I don't feel inclined to give away the rights to all of my photos at the moment.

Wednesday, 7 March 2012

He would be a red, obviously. An understated red. A light merlot from Napa Valley with hints of unconventionality and a slight medicinal flavour. An instantly forgettable beverage that you might buy in a family restaurant, and think "it's alright I guess". But, if you swirl the wine around in your glass, take a good sniff and let the liquid linger in your mouth, you detect a hint of stubborn bitterness and the slight unpleasantness of a budget wine trying to be something it's not.

On occasions when I talk about Jon Gerrard, I usually feel the need to start by saying "Jon's a nice guy, but..." because I never seem to have anything positive to say about him, even though I really do not dislike the guy. It's just that he's been ineffectual as a leader. He sucks at his job.

Case in point: in the televised debate last fall, Greg Selinger had the opportunity to finish up the evening by posing one question to the opponent of his choice. Did he direct his question to his primary rival, Hugh McFadyen? No. He picked on the mostly irrelevant Gerrard because he knew that Gerrard would flail like a wounded pigeon and allow Greg to score an indirect hit on Hugh without Hugh having an opportunity to respond.

In case you forgot what the question was, Greg asked Jon if he made a mistake in supporting the PC's bill to cut hundreds of doctors and nurses and plunge Manitoba health care into the Pleistocene era where we use sharpened rocks to perform surgery. Jon's response?

Gee. Gosh. Since you put it that way, I guess you're right! Gosh! How could I have been so stupid? Stoopid stoopid stoopid (banging head against podium).

That's a paraphrase only. I don't have the exact text of the debate in front of me so there might be some minor inaccuracies. In any case, you get the idea. A real leader would have said something like:

Mr.Selinger, as you well know the bill was not to cut nurses and doctors but to make some necessary decisions to control spending. The Manitoba government has over-spent its budget each of the last 11 years, we are running record deficits, our debt is skyrocketing, and our increasing reliance on transfer payments is threatening our ability to ensure quality health care and social services in the long term. A leader needs to be prepared to make difficult decisions, and one of those decisions is being responsible with the tax dollars that Manitobans sacrifice each year. If you're not prepared to make those difficult decisions Mr.Selinger, then Manitobans deserve a better Premier.

I got my own taste of Gerrard's stubborness last year at the Beers and Bipole debate organized by the Canadian Taxpayer Federation last summer. I suggested that it might be better to present a united front against the NDP's disasterous policy rather than muddying the issue with a third unrealistic option, but Gerard wouldn't budge. His way was the right way, and compromise was not even to be considered.

His stubborness could be the downfall of the Liberal Party in Manitoba. Jon has said he will step down in 2013, but he has also recently mused about running again in the only safe Liberal seat next election. "There may be an advantage to having somebody who has got some legislative experience serving behind a new leader in the next parliament" he says. That's bad news if you're a Liberal. As Steve Lambert wisely points out, hanging on to the River Heights seat could make it difficult to attract a quality leader because the prospect of getting elected and getting that MLA salary is diminished. Jon would quite likely remain the only Liberal in the Leg (if he even manages to get re-elected .. he hardly won by a landslide last time) and would therefore remain the dominant face of the Liberal party, even if he's not the leader.

Big changes are needed if the Libs are to reverse course and back away from the abyss. Members are revolting, Liberal bloggers are plotting new political parties and using the word "poop" a lot. This is a bad sign. Jon not only needs to step down as leader, he needs to leave the party completely. Get the hell out of there so they can turn the page and attempt to rebuild. If he sticks around then the Liberal Party is as good as dead.

Have you ever left an opened bottle of red wine on a window sill for 6 months by accident? Oh look, it's that bottle of Jon Gerrard from the Hallowe'en party. I wonder what it tastes like?

Saturday, 3 March 2012

This is so obvious that I'm sure somebody else has pointed this out already, but just in case ...

There are a couple of big stories coming out of Winnipeg City Hall these days. One has to do with a 20 cent transit fare increase to fund the first leg of the rapid transit corridor from downtown to the University of Manitoba. As one would expect, this has generated a storm of protest. People are upset, a web site has been created in opposition to the proposal, old men are breaking their hips in protest ... it's getting ugly out there folks. And what does this transit fare do for us? It nets us $7 million (rounded off) in annual revenue to put towards the rapid transit line.

Dan Lett, in the column linked to earlier, argues it should be spent on hockey rinks and community clubs. Not a bad idea, and other people may have other thoughts, but putting the cash back where it belongs will allow us to shelve the ridiculous transit fare increase and will buy us another year to allow Sammy and Greg to work through their embarrassingly disfunctional transit funding courtship.